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胸部超声检查在肺栓塞诊断中的临床价值:一项系统评价和荟萃分析

Clinical value of thoracic ultrasonography in the diagnosis of pulmonary embolism: a systematic review and meta-analysis.

作者信息

Chen Wu, Xu Kun, Li Yiying, Hao Meifang, Yang Yongsheng, Liu Xiaofang, Huang Xiaochun, Huang Yuqin, Ye Qianjun

机构信息

The First Hospital of Shanxi Medical University.

出版信息

Med Ultrason. 2022 May 25;24(2):226-234. doi: 10.11152/mu-3049. Epub 2021 Apr 22.

Abstract

AIMS

The present study investigated and evaluated the accuracy of thoracic ultrasonography (TUS) in the diagnosis of pulmonary embolism (PE) by conducting a systematic review and meta-analysis.

MATERIAL AND METHODS

The PubMed, Em-base and the Cochrane library databases were searched till March 2019 to retrieve relevant articles and the overall diagnostic accuracy of TUS in PE diagnosis was evaluated by meta-analysis.

RESULTS

Overall, 16 studies including 1,916 patients were enrolled in this meta-analysis. Of these, 762 (39.8%) had confirmed PE. The overall sensitivity, specificity, and area under the ROC curve (AUC) of TUS for PE were 82% (95% confidence interval (CI), 72%-88%), 89% (95% CI, 79%-95%), and 0.91 (95% CI, 0.88-0.93), respectively. Other efficacy parameters assessed demonstrated a positive likelihood ratio (PLR) of (7.6; 95% CI, 4.0-14.5), negative likelihood ratio of (NLR) (0.21; 95% CI, 0.14-0.30), and diagnostic odds' ratio (DOR) of (36.86; 95% CI, 21.41-63.48).

CONCLUSIONS

The current study suggested that although TUS cannot safely rule out PE, it is likely to be used as an aid or guidance to establish procedures and help to improve the diagnostic deficits in patients with PE.

摘要

目的

本研究通过系统评价和荟萃分析,调查并评估胸部超声检查(TUS)在诊断肺栓塞(PE)方面的准确性。

材料与方法

检索截至2019年3月的PubMed、Em-base和Cochrane图书馆数据库,以获取相关文章,并通过荟萃分析评估TUS在PE诊断中的总体诊断准确性。

结果

总体而言,本荟萃分析纳入了16项研究,共1916例患者。其中,762例(39.8%)确诊为PE。TUS诊断PE的总体敏感性、特异性和ROC曲线下面积(AUC)分别为82%(95%置信区间(CI),72%-88%)、89%(95%CI,79%-95%)和0.91(95%CI,0.88-0.93)。评估的其他疗效参数显示,阳性似然比(PLR)为(7.6;95%CI,4.0-14.5),阴性似然比(NLR)为(0.21;95%CI,0.14-0.30),诊断比值比(DOR)为(36.86;95%CI,21.41-63.48)。

结论

当前研究表明,虽然TUS不能安全地排除PE,但它可能有助于辅助或指导诊断流程,并有助于改善PE患者的诊断不足。

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